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Case Study/Concept Map– Endocrine System

Joe Clark, a 56-year-old male client, is postoperative 6 weeks after a total laryngectomy with a radical neck approach and reconstruction of the neck. He communicates via a Blom Singer prosthesis. Before surgery, he received 6 weeks of external beam radiation to help shrink the cancerous tumor. He has a past history of a kidney stone, which he passed. He had an intravenous pyleography (IVP) 2 months ago. He presents to the outpatient clinic for follow-up. He stated he feels extremely tired, and has problems remembering things and has to write lists as soon as he thinks of things he needs to do, or he forgets. He takes Metoprolol 100 mg daily, prednisone 5mg daily for inflammation, he is taking chemotherapy at the nearby Cancer Center.  He doesn’t remember his cancer meds, but his wife can bring in the list.  He has experienced a recent hair loss and dry skin and stated he feels cold all the time. The nurse notes that he is wearing a sweater and it is 80° F outside. The client has periorbital edema and puffiness of the hands and feet, which are cool to touch. The vital signs are T, 97° F; BP, 90/50 mm Hg; HR, 55 beats/minute; RR, 12 breaths/minute. Stools and Urine normal.  Lungs clear bibasilar throughout.  He also reports a recent steady weight gain, and he eats less food than he did in the past because his appetite is decreased. He asks the RN to explain the reason for the thyroid panel the physician ordered. CBC with Diff, CMP, UA, T3 T4 TSH.  


HbG 21.6

HCT 42

WBC  22

Bun and creatinine are high

No other noted abnormals in UA

a. What nursing management related to the diagnostic tests is necessary for the client considering the history?

b. Explain the reason for the thyroid panel and what comprises it, and what should the nurse predict the lab values will do in this case.

c. Prepare a Concept Map from the template on Blackboard under syllabus.  Please use other research besides Taber’s.  You may use your book for some of this but I would also like to see some NIH, CBC and other research completed.

You will need 2 medical diagnosis, one is primary and the other is secondary. Finish the section on meds and labs/diagnostic tests.  I only added a few.  Write a nurses note as to what you would think it would be from the case study.

Do one concept map.  I will attach the templates with this.